…Active gastric or duodenal ulcers. Liver cirrhosis. Severe heart failure. Doses 100 mg/day during the third trimester of pregnancy. Dosage Acute myocardial infarction: Initial…

…are distinguished by the history and the speed of the course. An AST/ALT ratio 2 with moderately raised values suggests alcohol related liver disease…

…sample. Indications Diagnostic paracentesis: Newly detected ascites — always. Every admission of a patient with known ascites. Clinical deterioration in a cirrhotic patient with ascites: fever…

…and vomiting 8 to 24 hours Alcoholic hallucinosis, often visual, auditory or tactile hallucinations with a relatively clear level of consciousness and preserved orientation 12…

…The following cardiomyopathies lead to dilation of the ventricle: Dilated cardiomyopathy (DCM) Idiopathic or genetic . Ischemic cardiomyopathy Alcoholic cardiomyopathy Diabetic cardiomyopathy Takotsubo cardiomyopathy Tachycardia induced…

…men on one occasion. Pharmacokinetics and pathophysiology Approximately 95% of ingested ethanol undergoes hepatic metabolism. Alcohol dehydrogenase converts ethanol to acetaldehyde, which is subsequently converted…

…alcohol, a missed meal, physical activity and any other precipitating factor. Thresholds The thresholds below are used above all in diabetes. The severity of the…

…there is a risk of blood contact. An alcohol or chlorhexidine swab. Let the skin dry completely before inserting the needle — alcohol carried in with…

…equipment Chlorhexidine in alcohol 5 mg/mL: clean with 3–4 swabs in wide circles and let it dry for a couple of minutes before…

…factors such as hypertension, abnormal renal/liver function, stroke history, bleeding history, labile INR, age 65, and concomitant drug/alcohol use. Some studies suggest HAS…

…Withdraw slowly. • Simultaneous use of tricyclic antidepressants reduces the effect of clonidine. • Clonidine increases the CNS depressive effects of alcohol and sedatives. Clonidine doses and…

…renal or liver function, previous stroke, history of bleeding, unstable anticoagulation control, advanced age, and the use of certain medications or alcohol. Interpretation of HAS…

…disease, kidney disease, alcohol excess, dietary factors and relevant medications. Cardiovascular risk category and the adequacy of LDL C lowering treatment. In severe primary HTG…

…toxins (alcohol, cocaine, cancer therapies), or physical reactions (radiation therapy), frequently involves the conduction system. In these conditions, involvement of the AVN and the conduction…

…weight, smoking, diet, physical inactivity, and alcohol consumption. Additional considerations include psychosocial stress, obstructive sleep apnoea, social determinants of health, air pollution, family history, ethnicity…

…older age, drugs predisposing to bleeding and alcohol use. A high bleeding risk score should prompt correction of modifiable risk factors and closer surveillance; it…

…thyrotoxicosis), alcohol overdose, thoracic surgery, acute myocardial infarction, pericarditis/myocarditis or pulmonary embolism is often a reversible arrhythmia with low risk of recurrence. Atrial fibrillation…

…many of the causes require prompt treatment. Inappropriate sinus tachycardia: When all the abovementioned causes have been ruled out and the sinus tachycardia persists without…

…by the position of the head relative to gravity: perform Dix Hallpike and, if needed, the supine roll test. Spontaneous attacks without a clear trigger…

…a small amount of lidocaine without adrenaline (epinephrine). 3. Puncture 1–2 cm proximal to the wrist crease at an angle of 30–45 degrees…

…What usually ruins the examination is not the technique but the handling of the specimen — an aspirate that clots before the smears are made is…

…is decided before the needle goes in: the choice of site, the use of ultrasound throughout the puncture, and maintaining maximal barrier precautions without shortcuts…

…Always follow the local protocol for exact infusion rates, electrolyte concentrations and level of care. This quick reference is intended primarily for adults and summarises…

…large ingestions of modified release preparations. Contraindications Measure Contraindication : : Medicinal charcoal A reduced level of consciousness without a protected airway — a risk of aspiration Medicinal…

…or with a history of gastrointestinal bleeding Refeeding syndrome There is a risk in starvation, alcoholism, anorexia nervosa, or more than 5 days without nutrition…

…the threshold, but the threshold varies between regions. Infection of the skin over the puncture site. Marked haemodynamic instability — stabilise the patient first. CT before…

…fold over the base of the plate. Preparation and equipment Chlorhexidine in alcohol or an iodine solution. Lidocaine 10 mg/mL without adrenaline for the…

…not exclude Diastolic collapse of the right atrium and right ventricle The cardinal echocardiographic finding A dilated inferior vena cava without respiratory variation Strongly suggests…

…a large bore cannula in a suitable vein). Standby access in a patient at risk of rapid deterioration. Intraosseous access: Cardiac arrest where venous access…

…All drains are inserted within the safe triangle (Figure 1). Outside it the risk of injuring the diaphragm, liver, spleen or internal thoracic artery increases…

…needed. Intubate for a threatened airway, a marked risk of aspiration, or failure that is not rapidly reversed by an antidote B Respiratory rate, saturation…

…lymphoma or granulomatous disease. A treatment resistant rash without a definite diagnosis. Choice of technique Diagnostic question Method Comment : : : Pigmented lesion, suspected melanoma Excision with…

…and short acting, not a depot preparation, and gives a shorter duration of effect. Lidocaine 10 mg/mL without adrenaline , 2–5 mL. Needles: 21…

…maximum dose of lidocaine is given in the Swedish medicines compendium (FASS) and in Swedish anaesthetic reviews as about 3–4 mg/kg without adrenaline…

…Abnormal renal/liver function, Stroke history, Bleeding history, Labile INRs, Elderly age ( 65), and Drugs/alcohol. A crucial clinical pitfall is the misapplication of this…

…symptoms suggestive of the five conditions listed above. It is important that history taking and physical examination is carried out systematically and carefully without delaying…

…Note: activated charcoal is ineffective against alcohols, lithium, and heavy metals. Enhance elimination Induce diuresis through urine alkalinization, contingent upon renal elimination of the toxicant…

…result of external causes, for example foreign body, hanging or strangulation. Drug overdose Intentional or accidental overdose of medications, drugs or other substances (including alcohol…

…90–95% of individuals with hypertension have essential hypertension , also referred to as primary hypertension . Essential hypertension is defined as hypertension without an identifiable underlying…